| Breast lesion removal (open) (19120) |
$1,778.40 |
$2,223 |
0.4× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge — not the full procedure |
$1,436.80 |
$1,796 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$972.80 |
$1,216 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$977.60 |
$1,222 |
1.1× |
| Diagnostic colonoscopy (45378) |
$1,316 |
$1,645 |
1.4× |
| Colonoscopy with biopsy (45380) |
$1,597.60 |
$1,997 |
1.3× |
| Colonoscopy with lesion removal (45385) |
$1,927.20 |
$2,409 |
1.6× |
| Laparoscopic gallbladder removal (47562) |
$3,171.20 |
$3,964 |
0.5× |
| Inguinal hernia repair (age 5+) (49505) |
$1,654.80 |
$2,068.50 |
0.5× |
| Laparoscopic radical prostatectomy (55866) |
$6,522.40 |
$8,153 |
0.6× |
| Obstetric care, vaginal delivery (global) (59400) |
$4,016.80 |
$5,021 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$4,748 |
$5,935 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$4,366.40 |
$5,458 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$955.60 |
$1,194.50 |
1.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$743.60 |
$929.50 |
0.8× |
| CT head/brain without contrast (70450) |
$662.80 |
$828.50 |
6.2× |
| MRI brain without contrast (70551) |
$334.40 |
$418 |
1.4× |
| MRI brain with contrast (70552) |
$930.80 |
$1,163.50 |
2.6× |
| MRI brain without and with contrast (70553) |
$519.20 |
$649 |
1.5× |
| X-ray lower spine, 4+ views (72110) |
$68 |
$85 |
0.6× |
| MRI lumbar spine without contrast (72148) |
$338.40 |
$423 |
1.4× |
| CT pelvis with contrast (72193) |
$776.80 |
$971 |
4.3× |
| MRI lower-extremity joint without contrast (73721) |
$385.60 |
$482 |
1.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,239.20 |
$1,549 |
3.5× |
| Ultrasound, abdomen complete (76700) |
$317.60 |
$397 |
3.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$377.20 |
$471.50 |
3.5× |
| Ultrasound, transvaginal (76830) |
$372 |
$465 |
3.5× |
| Mammography, one breast (diagnostic) (77065) |
$162 |
$202.50 |
1.9× |
| Mammography, both breasts (diagnostic) (77066) |
$221.20 |
$276.50 |
2.0× |
| Mammography, screening (bilateral) (77067) |
$237.20 |
$296.50 |
2.6× |
| Basic metabolic panel (80048) |
$26.40 |
$33 |
3.1× |
| Comprehensive metabolic panel (80053) |
$32 |
$40 |
3.0× |
| Obstetric panel (80055) |
$384 |
$480 |
8.0× |
| Lipid panel (80061) |
$63.20 |
$79 |
4.7× |
| Renal function panel (80069) |
$52.80 |
$66 |
6.1× |
| Hepatic function panel (80076) |
$44 |
$55 |
5.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$16 |
$20 |
4.0× |
| PSA, total (84153) |
$70.40 |
$88 |
3.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$24 |
$30 |
1.4× |
| CBC with automated differential (85025) |
$36.40 |
$45.50 |
4.7× |
| CBC, automated (85027) |
$34.40 |
$43 |
5.3× |
| Prothrombin time (PT) (85610) |
$17.20 |
$21.50 |
4.0× |
| Partial thromboplastin time (PTT) (85730) |
$40.80 |
$51 |
6.8× |
| Psychotherapy, 30 minutes (90832) |
$129.60 |
$162 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$168 |
$210 |
0.9× |
| Psychotherapy, 60 minutes (90837) |
$252 |
$315 |
1.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$160 |
$200 |
0.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$168 |
$210 |
0.9× |
| Group psychotherapy (90853) |
$56 |
$70 |
0.5× |
| Electrocardiogram (ECG), complete (93000) |
$80 |
$100 |
1.3× |
| Left heart catheterization (93452) |
$4,650.40 |
$5,813 |
1.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$90.40 |
$113 |
3.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$256 |
$320 |
1.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$382.40 |
$478 |
2.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$468 |
$585 |
3.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$346.40 |
$433 |
2.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$461.20 |
$576.50 |
3.4× |
| Preventive visit, new patient (age 18–39) (99385) |
$251.20 |
$314 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$246.40 |
$308 |
— |